0000950131-01-503869.txt : 20011030 0000950131-01-503869.hdr.sgml : 20011030 ACCESSION NUMBER: 0000950131-01-503869 CONFORMED SUBMISSION TYPE: 8-A12B PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20011026 FILER: COMPANY DATA: COMPANY CONFORMED NAME: ANTHEM INC CENTRAL INDEX KEY: 0001156039 STANDARD INDUSTRIAL CLASSIFICATION: HOSPITAL & MEDICAL SERVICE PLANS [6324] IRS NUMBER: 352145715 STATE OF INCORPORATION: IN FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 8-A12B SEC ACT: 1934 Act SEC FILE NUMBER: 001-16751 FILM NUMBER: 1766968 BUSINESS ADDRESS: STREET 1: 120 MONUMENT CIRCLE CITY: INDIANAPOLIS STATE: IN ZIP: 46204 BUSINESS PHONE: 3174886000 8-A12B 1 d8a12b.txt FORM 8-A FORM 8-A SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FOR REGISTRATION OF CERTAIN CLASSES OF SECURITIES PURSUANT TO SECTION 12(b) OR (g) OF THE SECURITIES EXCHANGE ACT OF 1934 Anthem, Inc. -------------------------------------------------------------------------------- (Exact name of registrant as specified in its charter) Indiana 35-2145715 -------------------------------------------------------------------------------- (State of incorporation (I.R.S. Employer or organization) Identification No.) 120 Monument Circle Indianapolis, Indiana 46204 -------------------------------------------------------------------------------- (Address of principal executive offices) (Zip Code) Securities to be registered pursuant to Section 12(b) of the Act: Title of each class Name of each exchange on which to be so registered each class is to be registered --------------------- ------------------------------ Equity Security Units New York Stock Exchange If this form relates to the registration of a class of securities pursuant to Section 12(b) of the Exchange Act and is effective pursuant to General Instruction A.(c), check the following box.[X] If this form relates to the registration of a class of securities pursuant to Section 12(g) of the Exchange Act and is effective pursuant to General Instruction A.(d), check the following box.[ ] Securities Act registration statement file number to which this form relates: 333-70566 Securities to be registered pursuant to Section 12(g) of the Act: None. ITEM 1. DESCRIPTION OF REGISTRANT'S SECURITIES TO BE REGISTERED. The class of securities to be registered hereby are the Equity Security Units of Anthem, Inc. (the "Units"). For a description of the Units, reference is made to the information set forth under the heading "Description of the Units" in the prospectus which forms a part of Anthem, Inc.'s Registration Statement on Form S-1 (Registration No. 333-70566), filed with the Securities and Exchange Commission on October 1, 2001, as amended by any amendments to such Registration Statement, and by any prospectus subsequently filed pursuant to Rule 424(b) under the Securities Act of 1933, as amended, which description is incorporated herein by reference. ITEM 2. EXHIBITS. The following exhibits are filed as a part of this Registration Statement. EXHIBIT NO. DESCRIPTION ----------- ----------- 1 Anthem, Inc.'s Registration Statement on Form S-1 (Registration No. 333-70566), as amended, including any prospectus filed pursuant to Rule 424(b) under the Securities Act (incorporated herein by reference). 2 Restated Articles of Incorporation of Anthem, Inc. (incorporated herein by reference to Exhibit 3.1 to the Anthem, Inc. Registration Statement on Form S-1 (Registration No. 333-67714)). 3 By-Laws of Anthem, Inc. (incorporated herein by reference to Exhibit 3.2 to the Anthem, Inc. Registration Statement on Form S-1 (Registration No. 333-67714)). 4 Form of Indenture between Anthem, Inc. and The Bank of New York, as trustee, relating to the debt securities (incorporated herein by reference to Exhibit 4.3 to the Anthem, Inc. Registration Statement on Form S-1 (Registration No. 333-70566)). 5 Form of First Supplemental Indenture between Anthem, Inc. and The Bank of New York, as trustee, relating to the Debentures (incorporated herein by reference to Exhibit 4.4 to the Anthem, Inc. Registration Statement on Form S-1 (Registration No. 333- 70566)). 6 Form of Purchase Contract Agreement (incorporated herein by reference to Exhibit 4.5 to the Anthem, Inc. Registration Statement on Form S-1 (Registration No. 333-70566)). 2 7 Form of Pledge Agreement (incorporated herein by reference to Exhibit 4.6 to the Anthem, Inc. Registration Statement on Form S-1 (Registration No. 333-70566)). 8 Form of Debenture (incorporated herein by reference to Exhibit 4.7 to the Anthem, Inc. Registration Statement on Form S-1 (Registration No. 333-70566)). 9 Form of Normal Unit (incorporated herein by reference to Exhibit 4.8 to the Anthem, Inc. Registration Statement on Form S-1 (Registration No. 333-70566)). 10 Form of Stripped Unit (incorporated herein by reference to Exhibit 4.9 to the Anthem, Inc. Registration Statement on Form S-1 (Registration No. 333-70566)). 11 Form of Remarketing Agreement (incorporated herein by reference to Exhibit 4.10 to the Anthem, Inc. Registration Statement on Form S-1 (Registration No. 333-70566)). 3 SIGNATURE Pursuant to the requirements of Section 12 of the Securities Exchange Act of 1934, the Registrant has duly caused this Registration Statement to be signed on its behalf by the undersigned, thereto duly authorized. ANTHEM, INC. Date: October 24, 2001 By: /s/ David R. Frick ----------------------------------------- Name: David R. Frick Title: Executive Vice President and Chief Legal and Administrative Officer 4 EXHIBIT INDEX -------------
EXHIBIT NO. DESCRIPTION ----------- ----------- 1 Anthem, Inc.'s Registration Statement on Form S-1 (Registration No. 333-70566), as amended, including any prospectus filed pursuant to Rule 424(b) under the Securities Act (incorporated herein by reference). 2 Restated Articles of Incorporation of Anthem, Inc. (incorporated herein by reference to Exhibit 3.1 to the Anthem, Inc. Registration Statement on Form S-1 (Registration No. 333-67714)). 3 By-Laws of Anthem, Inc. (incorporated herein by reference to Exhibit 3.2 to the Anthem, Inc. Registration Statement on Form S-1 (Registration No. 333-67714)). 4 Form of Indenture between Anthem, Inc. and The Bank of New York, as trustee, relating to the debt securities (incorporated herein by reference to Exhibit 4.3 to the Anthem, Inc. Registration Statement on Form S-1 (Registration No. 333-70566)). 5 Form of First Supplemental Indenture between Anthem, Inc. and The Bank of New York, as trustee, relating to the Debentures (incorporated herein by reference to Exhibit 4.4 to the Anthem, Inc. Registration Statement on Form S-1 (Registration No. 333-70566)). 6 Form of Purchase Contract Agreement (incorporated herein by reference to Exhibit 4.5 to the Anthem, Inc. Registration Statement on Form S-1 (Registration No. 333-70566)). 7 Form of Pledge Agreement (incorporated herein by reference to Exhibit 4.6 to the Anthem, Inc. Registration Statement on Form S-1 (Registration No. 333-70566)). 8 Form of Debenture (incorporated herein by reference to Exhibit 4.7 to the Anthem, Inc. Registration Statement on Form S-1 (Registration No. 333-70566)). 9 Form of Normal Unit (incorporated herein by reference to Exhibit 4.8 to the Anthem, Inc. Registration Statement on Form S-1 (Registration No. 333-70566)). 10 Form of Stripped Unit (incorporated herein by reference to Exhibit 4.9 to the Anthem, Inc. Registration Statement on Form S-1 (Registration No. 333-70566)). 11 Form of Remarketing Agreement (incorporated herein by reference to Exhibit 4.10 to the Anthem, Inc. Registration Statement on Form S-1 (Registration No. 333-70566)).
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